Effect of Severity on Treatment Entry Following Substance Abuse Onset

Background: Understanding the relationship between substance abuse severity and time to treatment from substance abuse onset is essential to increase access to and tailor treatment services. The current study, part of a larger longitudinal study examining paths leading to substance use among a community sample of African Americans, examined the time to substance abuse treatment in mid-life (42-43 years) among those meeting the criteria for substance abuse or dependence by young adulthood (32-33 years). Methods:Descriptive techniques and survival analysis were used to examine differences in time to treatment among those with substance abuse or dependence (n=145). Results: The results show the mean age of abuse onset was in the late 20s. However, the mean age of first treatment episode was in the early/mid 30s. The mean time from abuse onset to treatment was 12 years for abuse and 11 years for dependence. Further,those diagnosed with dependence reported treatment significantly more often those diagnosed with abuse (p<0.001) and received treatment significantly sooner than those with abuse. Conclusions: The findings suggest that substance abuse onset into adulthood is a concern, particularly because those with adult onset do not appear to receive treatment soon after abuse onset. While those with dependence do report treatment sooner than those with abuse, individuals with high severity take over a decade to initiate treatment contact. Further, the findings suggest the need fortreatment interventions to focus additional resources on those with abuse diagnoses with the hopes of minimizing thosethat transition to dependence.